The aetiology, management, and results of acute rupture of primary flexor tendon repairs in Zones I and II of the fingers in children have not been previously investigated. The author reports on a personal series of 10 children treated over a period of 13 years. The aetiology is different when compared with adults: children less than 5 years of age usually rupture their primary repairs whilst the hand is completely immobilized in a cast; whereas teenagers usually rupture their tendons when falling down while playing. In the current series, direct re-repair was performed without lengthening at the musculo-tendinous junction, and no free tendon grafts were used. The results were worse than other paediatric series of primary flexor tendon repairs. Using the Strickland-Glogovac criteria, there was only one excellent outcome, the remaining nine being either a good (n = 5) or fair (n = 4) outcome.